S(ummer) Affective Disorder

July 5, 2011

You may have heard of the winter equivalent, but this is a new one on me. However it just so happens that I may be one of the few who does not look forward to summer and are generally much happier in the autumn and winter months.

This summertime mood disorder was first recognized as a form of depression in 1986 and is thought to affect less than one percent of the population, making it much rarer than the winter variety experienced by an estimated 5 percent of people. If you suffer from SAD then your symptoms mean you sleep less, eat less, and lose weight and are extremely irritable and agitated.

Dr. Norman Rosenthal, a clinical professor of psychiatry at Georgetown University Medical School, who has studied both types and first helped discover their existence believes that people with summer seasonal depression may be more at risk for suicide than cold-weather SAD types. He said “Suicide is more of a concern when people are depressed and agitated rather than depressed and lethargic.”

Rosenthal also said that mental health professionals suspected the cause was the heat and humidity. That, he said, lent itself to the idea that a cold shower, air conditioning, swimming in cold lakes or heading North would relieve symptoms. Although these treatments for hot-weather depression are useful for some, they lack the staying power that light-box therapy has on winter SAD.

Rosenthal is the author of “Winter Blues” and says that a person with summer SAD can stay inside, crank up the AC, and darken the room but then go outside into the heat and it’s as if they’ve never been treated. Another idea is that it might be the light itself that’s aggravating sufferers, whether it’s the intensity of sunlight or the angle it’s coming at people.

Still another possibility is that there may be two kinds of warm-weather depression, says Dr. Alfred Lewy, a professor of psychiatry at Oregon Health & Science University in Portland. He suggests there might be one group of people who have an unpleasant reaction to the heat and humidity — a discomfort with the climate. But even in Portland where summers aren’t that hot or humid, he’s seen patients struggle with summer depression. Lewy suspects the cause in a second group might be that the body’s natural clock, it’s circadian rhythms, are misaligning in summer. Instead of cueing to dawn, the longer daylight is causing some vulnerable people to cue to dusk. Cueing to dusk shortens the typical body clock and delays a person’s sleep-wake cycle. This mismatch, theorizes Lewy, may be triggering depression.

He successfully treated a person with summer depression with a combination of getting early morning sunlight (30 to 60 minutes daily), which shifts the body clock forward, and low-dose melatonin, a hormone that helps regulate sleep-wake cycles. Severe symptoms may also benefit from antidepressants.